Day 4

A whole day travelling round Katine visiting old friends – wonderful. I come away with a record load of gifts – a basinful of shelled groundnuts, four oranges, two eggs, a watermelon and a hen.

This last I couldn't believe was for me. When the children were catching it, I was afraid it was going to be cooked for me. Worse – it ended up flapping around the jeep. I managed to give it back, though, explaining that we are not allowed to take them on planes.

First, I saw Mary Amulo, who once tried to give me her baby son. She said it was like handing him over to a richer relative to bring up and not a big deal at all. I would bring him to visit. Hard to imagine anybody parting with their child, but I think she genuinely thought he would have a better life – and so would the rest of the family through my support and later, his.

The extended family in Uganda is a financial as much as an emotional network. Anybody with a job can expect to to tapped for help by every relative, however remote. John Bosco, my driver, has 10 children in his Soroti house (his real home is in rural Katine), only four of whom are his. The rest are nieces and nephews whom he looks after and who get the chance of schooling in town.

Mary has been very unwell, she and everybody else tells me. Malaria and pneumonia are part of it but I have a bad feeling there may be more. She has been complaining of pains in her side since the baby was born nearly two years ago. We take her for yet another check-up at the health centre. There are drugs, so anybody with a problem will be turning up.

Then I saw Sister Josephine, the leader of the traditional birth attendants, whom the government has now banned from working. It's the first time I've seen her out of uniform. I arrive at her compound and the children fetch her from her garden, as everybody calls their vegetable plots. She is 78, her back is now crooked and yet she is still digging the earth.

She says she dreamed about me. That's alarming! She has officially stopped delivering babies. She was very unhappy when she was escorting a pregnant woman to the health centre so that the midwives could deliver her, and was shouted at by one of the medical staff, who said she would get seven years in jail. Hardly the treatment she deserves after all the help she has given her community.

Among the others I visited was Ida, a young girl I saw two years ago in a huge and ragged family, who said she was turned away from school for not having a uniform but wanted to be a doctor. I got her a uniform which cost a couple of pounds in the market and now she is in the last year of primary school. She's still bright-eyed and smart and was 8th in the class (out of nearly 100) last year.

This time she said she wanted to be a nurse. Her expectations are lowered, or unfortunately tempered with realism. Her father has 28 children. Even John Bosco, my driver, snorted in disbelief and talked about it for miles. Ten other babies died, as did one of this man's three wives.

I asked the father whether he was going to have any more children and he said he didn't want any more. No sign of him doing anything about it, though – both wives were holding small babies. Bosco told me he'd never heard of a vasectomy, but he said a man would never consent to an operation. And a woman cannot get contraception unless her husband goes with her.

Day 5

Back to work? Village health teams in Katine, seen here waiting to receive gumboots from Amref, may be close to ending their strike. Photograph: Joseph Malinga guardian.co.uk

Last day in Katine, though I hope not the last ever. I try to see Loyce, a former nurse who owns a drug shop in Tiriri, just down from the health centre. When there are stock-outs (drug deliveries), she gets a lot of business. The medical staff tell patients what to buy, including fluid for intravenous drips, canulas and and quinine for severe malaria. The drips are hung up in the ward on wire coat hangers attached to window frames above the beds.

Today, though, Loyce is in town, as she was yesterday, so I'm out of luck. It looks to me as if business may have suffered in Tiriri high street (a small row of lockable shacks with rusting corrugated iron roofs). The wonderful new road has bypassed it completely so they have no passing trade. It used to bustle. Now it looks like one of those deserted streets in the windy Wild West when everybody in town has hidden because the bandits are coming.

I chat to some women at a new borehole installed by the African Medical Research Foundadtion (Amref), and they are hugely grateful for their clean water. Everybody I have spoken to has said how much the project has achieved and how grateful they are – even those who go on to voice a complaint or ask for more. I don't think it's just politeness.

I am slightly worried, though, by the sense from everyone that the project is ending. In fact, there is another year to go and plenty more work to be done. I keep saying this to people. It's so easy to get into winding-up mode instead of remaining innovative and enthusiastic. ,

It's also important that people in Katine really believe they can take things on by themselves – that they don't have to depend on Amref. A PTA chairman said they were worried about what would happen to the community centre with its computers in the project office. He is on the committee that is supposed to oversee it. I suggested they should start negotiating right now.

I have a chat with the project manager, who says they are now proposing to pay the VHTs a small allowance again – probably Ushs 3,000 (about 85 pence) and a snack. Let's hope that does the trick and solves the dispute that caused them to strike. Then we head back to Kampala. I've got lots to write and loads of memories. And a sackful of groundnuts in my luggage.